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  "documentTitle": "Inspire Medical Systems, Inc. (INSP)",
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  "presentationDate": "2020-04-22 00:00:00",
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  "notes": "Includes a comparative table of clinical outcomes (AHI/ODI reduction) and expert commentary on market positioning.",
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      "text": "In its 12 month pilot study, LivaNova’s patients saw a mean reduction in AHI of 53% after 12 months and a mean ODI reduction of around 50% - almost exactly the same as Inspire.",
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      "text": "Numerous non-invasive options already exist: Oral appliance therapy is an effective, non-invasive treatment that fits easily into the patient's lifestyle. They are completely non-invasive, easy to wear, comfortable, convenient and don't come with a long list of restrictions or a $40,000+ price tag.",
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      "text": "Nyxoah: Nyxoah, a privately held Belgian company, is currently on the path for commercial launch in the U.S. It received CE approval in Europe during 2019. ResMed is the leading CPAP manufacturer globally. Their investment in Nyxoah provides it the sales infrastructure and FDA trial experience to quickly compete with Inspire and should be concerning for Inspire investors. The Nyxoah device is powered by an external battery pack, so it doesn't require an additional surgery to replace the battery every 7 to 10 years.",
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      "text": "LivaNova: LivaNova is a mid-sized listed, profitable company, which owns a portfolio of products including a number of neurostimulation devices. It has extensive experience rolling out new neurostimulation devices and an existing sales infrastructure from its acquisition of Imthera last year. LivaNova is currently reconfirming trial results ahead of an FDA submission, which is expected to be made later this year. In its 12 month pilot study, LivaNova's patients saw a mean reduction in AHI of 53% after 12 months and a mean ODI reduction of around 50% - almost exactly the same as Inspire. The LivaNova device requires no DISE procedure ahead of implant, and does not rely on a chest-implanted sensor, so the surgery is less invasive.",
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      "kind": "quote",
      "text": "In their literature, Inspire almost pretends that oral appliances don't exist Oral appliances are a much better first choice. A dentist makes it for you, and ADA is cranking out dentists who make these.",
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      "text": "\"In their literature, Inspire almost pretends that oral appliances don’t exist Oral appliances are a much better first choice. A dentist makes it for you, and ADA is cranking out dentists who make these.\" — Sleep doctor expert call, February 2020",
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      "text": "Footnotes 39-43 detailing sources for clinical data and expert calls.",
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